No abstract available.
Gastrectomy*

No abstract available.
Gastrectomy*

No abstract available.
Gastrectomy*

No abstract available.
Gastrectomy*

No abstract available.
Gastrectomy*

No abstract available.
Gastrectomy

PURPOSE: To evaluate the usefulness of prone pad study in upper gastrointestinal series(UGIS) for thedetection of early gastric cancer(EGC). MATERIALS AND METHODS: During an eight-month period, 88 of 170 patientswho underwent gastrectomy due to EGC were also the subjects of prone pad study as well as double contrast(n=92),mucosal relief(n=76), or compression(n=91) studies. The EGCs were single in 84 patients and double in four. Wecompared prone pad study with the three other techniques for detecting a tumor and depicting the surroundingmucosal changes. Lesional conspicuity was rated 'complete', 'incomplete','suspicious'. or 'undetected'. Thedepiction of surrounding mucosal change was rated 'excellent', 'good', 'fair', or 'poor'. RESULTS: Mean tumorsize was 3.2cm, with a range of 0.3-9cm. Tumors were located in the antrum(n=55), angle(n=13), lower or midbody(n=16), or the sign body and cardia(n=5). Among the 92 EGCs evaluated, UGIS missed the lesion in threecases(sensitivity, 97%). The rates of 'complete' lesional conspicuity were 49% inn prone pad, 29% in compression,20% in double contrast, and 9% in mucosal relief. The rates of excellent' in depicting surrounding mucosal changewere 45% in prone pad, 11% in double contrast, 9% in mucosal relief, and 9% in compression. The tumor wasdemonstrated only in prone pad study in five(5%) of the 92 EGCs. CONCLUSION: prone pad study during UGIS improvesboth the detection rate of EGC and the depiction of mucosal change around the tumor.
Gastrectomy ; Humans

It had heen emphasized the necessity for upper gastrointestinal endoscopic examinations in patients. Who has had gastrectomy and presents persisting gastrointestinal symptoms. This study was conducted to evaluate endoscopic findings and clinical symptoms in patients following gastrectomy. (continue...)
Gastrectomy* ; Humans

PURPOSE: Despite knowledge of the adverse effects of resection-line disease, surgeons continue to perform inadequate resections. This demonstrates the need for a more aggressive approach to assessment of resection margins at operation. MATENRIALS AND METHODS: Seven hundred fifteen gastric cancer patients who were operated on at our hospital from 1992 to 1998 were included in this analysis. Various clinico- pathological factors, including resection-line involvement, were ascertained from the surgical and histopathological records. RESULTS: Of the 715 evaluable patients, 27 patients (3.8%) had involvement of one or both resection lines; in 10 patients the proximal resection line only, in 16 the distal resection line only, and 1 both resection lines were involved. Presence of resection-line involvement was significantly associated with T3 and T4 stage, N (+) stage, M (+) stage, type of operation (total gastrectomy), tumor location (entire stomach), size > or =11 cm), and gross type of tumor (Borrmann 4 type). When performing a distal subtotal gastrectomy, no involvement was found when the cranial and caudal distances between the lesion and the line of transection was equal to or greater than 2 cm and 3 cm, respectively, for early cancer and 7 cm and 3 cm, respectively, for advanced cancer. When performing a total gastrectomy for upper 1/3 or middle 1/3 gastric cancer, no involvement was found when the cranial distances between the lesion and the line of transection were equal to or greater than 3 cm and 4cm, respectively, without distinction of the presence of serosal invasion. CONCLUSION: The difference in survival between positive and negative margin patients is limited to the group of patients with curative surgery. An important principle of treatment is that the entire tumor must be removed with a 3 cm distal margin and a 2- to 7 cm margin depending on the location and the depth of wall invasion of the tumor, to provide histologically negative margins.
Gastrectomy ; Humans ; Stomach Neoplasms*

PURPOSE: To evaluate and compare the diagnostic accuracy of MRI and ultrasound(US) for estimation of invasion depth of gastric carcinoma by correlation with histopathologic findings in vitro and to find out the best MR pulse sequence for detection and accurate delineation of tumor. MATERIALS AND METHODS: Resected specimen of total or subtotal gastrectomy from 53 patients with gastric carcinoma were done of imaging studies of MRI and US. And US was examined by using high frequency linear transducer for tumor invasion depth by a radiologist. In each case, both imaging findings of MRI and US were evaluated independently for tumor detection and invasion depth by consensus of two radiologists and were compared the diagnostic accuracy between two imaging modalities according to the histopathologic findings. MR imaging with five MR pulse sequences, spin echo T1 and in- and out-ofphase gradient echo T1 weighted images, FSE and SSFSE T2 weighted images, were performed. Five MR pulse sequences were evaluated and compared on the point of detection and accurate distinction of tumor from surrounding normal tissue. RESULTS: In EGC, diagnostic accuracy of US(77%) was superior than that of MRI(59%) but no statistically significant difference was noted between two imaging modalities(p=0.096). In AGC, both imaging modalities of MRIand US showed relatively high diagnostic accuracy as 97% and 84% respectively. Diagnostic accuracy of MRI was statistically better than that of US at the significant level(p<0.001). The best MR pulse sequence among five in each specimen was FSE T2WI(75.5%, 40/53) in both EGC and AGC. In AGC, FSE T2WI showed excellent imaging quality by showing very high ratio (93.5%, 29/31) of accurate delineation of tumor. CONCLUSION: MRI and US show relatively high diagnostic accuracy in the evaluation of tumor invasion depth of resected specimen in AGC. The most excellent pulse sequence of MRI for the evaluation of tumor invasion depth is FSE T2WI on the point of detection and accurate delineation of tumor in both EGC and AGC.
Consensus ; Gastrectomy ; Humans ; Transducers